Healthcare Provider Details

I. General information

NPI: 1033279138
Provider Name (Legal Business Name): ROBERT A. ALWORTH DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 05/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1115 ARNOLD AVE
POINT PLEASANT BORO NJ
08742-2312
US

IV. Provider business mailing address

1115 ARNOLD AVE
POINT PLEASANT BORO NJ
08742-2312
US

V. Phone/Fax

Practice location:
  • Phone: 732-892-2100
  • Fax: 732-892-2111
Mailing address:
  • Phone: 732-892-2100
  • Fax: 732-892-2111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number25MD00157700
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License Number25MD00157700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: